小儿手术时间与pcnl后SIRS之间的饱和效应。

IF 2.9 2区 医学 Q2 UROLOGY & NEPHROLOGY
Nueraili Abudurexiti, Xun Li, Bide Liu, Shuheng Wang, Qiang Dong
{"title":"小儿手术时间与pcnl后SIRS之间的饱和效应。","authors":"Nueraili Abudurexiti, Xun Li, Bide Liu, Shuheng Wang, Qiang Dong","doi":"10.1007/s00345-025-05869-x","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Prolonged operation time has been associated with an increased incidence of postoperative complications in various surgical procedures. However, its role in pediatric percutaneous nephrolithotomy (PCNL) remains unclear. This study aimed to investigate the relationship between operation time and systemic inflammatory response syndrome (SIRS) incidence in pediatric patients undergoing PCNL.</p><p><strong>Methods: </strong>This retrospective study included 472 pediatric patients who underwent PCNL, the primary exposure of interest was operation time, while the primary outcome was the incidence of postoperative SIRS. Multivariate logistic regression, restricted cubic spline (RCS) analysis, and two-piecewise linear regression models were used to assess the relationship and potential threshold effects between operation time and postoperative SIRS. Subgroup analyses were used to investigate the association across different subgroups.</p><p><strong>Results: </strong>The median age of the patients was 7 years (interquartile range: 3-12), and 56.36% were male. The median operation time was 80 min (interquartile range: 70-95). Postoperatively, 90 patients developed SIRS, accounting for 19.07% of the total cohort. In the fully adjusted model, compared with the low operation time group, the adjusted odds ratios (95% confidence intervals) for postoperative SIRS were 2.63 (1.20, 5.83) for the medium operation time group and 2.86 (1.28, 6.54) for the high operation time group, respectively. RCS with threshold effect analysis revealed a saturation effect between operation time and postoperative SIRS, with a threshold identified at 70 min. Subgroup analyses indicated that underweight pediatric patients are more susceptible to the effects of operation time.</p><p><strong>Conclusion: </strong>Prolonged operation time in pediatric patients undergoing PCNL is an independent risk factor for postoperative SIRS, with a non-linear saturation effect relationship and a threshold effect. These findings may contribute to the optimization of surgical strategies for pediatric PCNL aimed at reducing postoperative SIRS.</p>","PeriodicalId":23954,"journal":{"name":"World Journal of Urology","volume":"43 1","pages":"498"},"PeriodicalIF":2.9000,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Saturation effect between operation time and post-PCNL SIRS in pediatric patients.\",\"authors\":\"Nueraili Abudurexiti, Xun Li, Bide Liu, Shuheng Wang, Qiang Dong\",\"doi\":\"10.1007/s00345-025-05869-x\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Prolonged operation time has been associated with an increased incidence of postoperative complications in various surgical procedures. However, its role in pediatric percutaneous nephrolithotomy (PCNL) remains unclear. This study aimed to investigate the relationship between operation time and systemic inflammatory response syndrome (SIRS) incidence in pediatric patients undergoing PCNL.</p><p><strong>Methods: </strong>This retrospective study included 472 pediatric patients who underwent PCNL, the primary exposure of interest was operation time, while the primary outcome was the incidence of postoperative SIRS. Multivariate logistic regression, restricted cubic spline (RCS) analysis, and two-piecewise linear regression models were used to assess the relationship and potential threshold effects between operation time and postoperative SIRS. Subgroup analyses were used to investigate the association across different subgroups.</p><p><strong>Results: </strong>The median age of the patients was 7 years (interquartile range: 3-12), and 56.36% were male. The median operation time was 80 min (interquartile range: 70-95). Postoperatively, 90 patients developed SIRS, accounting for 19.07% of the total cohort. In the fully adjusted model, compared with the low operation time group, the adjusted odds ratios (95% confidence intervals) for postoperative SIRS were 2.63 (1.20, 5.83) for the medium operation time group and 2.86 (1.28, 6.54) for the high operation time group, respectively. RCS with threshold effect analysis revealed a saturation effect between operation time and postoperative SIRS, with a threshold identified at 70 min. Subgroup analyses indicated that underweight pediatric patients are more susceptible to the effects of operation time.</p><p><strong>Conclusion: </strong>Prolonged operation time in pediatric patients undergoing PCNL is an independent risk factor for postoperative SIRS, with a non-linear saturation effect relationship and a threshold effect. These findings may contribute to the optimization of surgical strategies for pediatric PCNL aimed at reducing postoperative SIRS.</p>\",\"PeriodicalId\":23954,\"journal\":{\"name\":\"World Journal of Urology\",\"volume\":\"43 1\",\"pages\":\"498\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2025-08-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World Journal of Urology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00345-025-05869-x\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of Urology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00345-025-05869-x","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0

摘要

背景:在各种外科手术中,手术时间的延长与术后并发症的发生率增加有关。然而,其在儿童经皮肾镜取石术(PCNL)中的作用尚不清楚。本研究旨在探讨小儿PCNL患者手术时间与全身炎症反应综合征(SIRS)发生率的关系。方法:回顾性研究472例行PCNL的患儿,主要关注的是手术时间,主要观察指标是术后SIRS的发生率。采用多元逻辑回归、受限三次样条(RCS)分析和两分段线性回归模型评估手术时间与术后SIRS之间的关系和潜在阈值效应。亚组分析用于调查不同亚组之间的关联。结果:患者年龄中位数为7岁(四分位数范围3 ~ 12岁),男性占56.36%。手术时间中位数为80 min(四分位数范围:70-95)。术后有90例患者发生SIRS,占总队列的19.07%。在完全调整模型中,与低手术时间组相比,中等手术时间组术后SIRS的调整优势比(95%可信区间)为2.63(1.20,5.83),高手术时间组术后SIRS的调整优势比(95%可信区间)为2.86(1.28,6.54)。RCS阈值效应分析显示手术时间与术后SIRS之间存在饱和效应,阈值在70 min。亚组分析表明,体重过轻的儿童患者更容易受到手术时间的影响。结论:小儿PCNL患者手术时间延长是术后SIRS的独立危险因素,且存在非线性饱和效应关系和阈值效应。这些发现可能有助于优化儿科PCNL的手术策略,以减少术后SIRS。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Saturation effect between operation time and post-PCNL SIRS in pediatric patients.

Background: Prolonged operation time has been associated with an increased incidence of postoperative complications in various surgical procedures. However, its role in pediatric percutaneous nephrolithotomy (PCNL) remains unclear. This study aimed to investigate the relationship between operation time and systemic inflammatory response syndrome (SIRS) incidence in pediatric patients undergoing PCNL.

Methods: This retrospective study included 472 pediatric patients who underwent PCNL, the primary exposure of interest was operation time, while the primary outcome was the incidence of postoperative SIRS. Multivariate logistic regression, restricted cubic spline (RCS) analysis, and two-piecewise linear regression models were used to assess the relationship and potential threshold effects between operation time and postoperative SIRS. Subgroup analyses were used to investigate the association across different subgroups.

Results: The median age of the patients was 7 years (interquartile range: 3-12), and 56.36% were male. The median operation time was 80 min (interquartile range: 70-95). Postoperatively, 90 patients developed SIRS, accounting for 19.07% of the total cohort. In the fully adjusted model, compared with the low operation time group, the adjusted odds ratios (95% confidence intervals) for postoperative SIRS were 2.63 (1.20, 5.83) for the medium operation time group and 2.86 (1.28, 6.54) for the high operation time group, respectively. RCS with threshold effect analysis revealed a saturation effect between operation time and postoperative SIRS, with a threshold identified at 70 min. Subgroup analyses indicated that underweight pediatric patients are more susceptible to the effects of operation time.

Conclusion: Prolonged operation time in pediatric patients undergoing PCNL is an independent risk factor for postoperative SIRS, with a non-linear saturation effect relationship and a threshold effect. These findings may contribute to the optimization of surgical strategies for pediatric PCNL aimed at reducing postoperative SIRS.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
World Journal of Urology
World Journal of Urology 医学-泌尿学与肾脏学
CiteScore
6.80
自引率
8.80%
发文量
317
审稿时长
4-8 weeks
期刊介绍: The WORLD JOURNAL OF UROLOGY conveys regularly the essential results of urological research and their practical and clinical relevance to a broad audience of urologists in research and clinical practice. In order to guarantee a balanced program, articles are published to reflect the developments in all fields of urology on an internationally advanced level. Each issue treats a main topic in review articles of invited international experts. Free papers are unrelated articles to the main topic.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信